Health in the Democratic Republic of the Congo

The healthcare system of the Democratic Republic of the Congo includes public, faith-based, private, and nongovernmental-organization-run facilities. The Ministère de la Santé Publique, Hygiène et Prévoyance Sociale (Ministry of Public Health, Hygiene and Social Welfare) operates through provincial and health-zone structures. The country is divided into 26 provinces and 519 zones de santé (health zones); within a zone, local aires de santé (health areas) provide care. A health center (Centre de Santé) or referral health center (Centre de Santé de Référence) is usually the first medical point of contact. In case of complications, the facility issues a referral slip (bon de référence) to a general referral hospital (Hôpital Général de Référence). Tertiary and university clinics treat particularly complex cases. Prevention and early detection come before treatment. Relais communautaires (community health relays) and other Community Health Workers visit households, identify complaints, mobilize people for vaccinations, screen children for malnutrition, and direct them to suitable facilities. Services include antenatal checkups, family planning, HIV, tuberculosis, and malaria prevention, nutrition counseling, and health education. The national immunization program provides nine appointments from birth to 15 months of age. These include vaccinations against tuberculosis, polio, pneumococcal disease, diphtheria, tetanus, whooping cough, hepatitis B, Haemophilus influenzae type b, rotavirus, measles, rubella, and yellow fever. Since 2024, the routine schedule has also included four malaria vaccine doses from six months of age. Routine vaccinations are officially free and mandatory; practical access may vary by health zone. During treatment, quality and speed depend heavily on the particular facility. Before visiting, check locally whether it is open, the staff's qualifications, access to laboratory services, medicine availability, and prices. The 2020 national list of essential medicines provides a professional basis, but supply chains are fragmented and so-called stock-outs can occur. A pharmacy or health center may therefore temporarily be unable to provide a prescribed medicine. Transport problems, conflict, displacement, costs, and temporary closures can also prevent a referral or follow-up visit. Acute diseases and outbreaks are addressed through regional emergency and epidemic structures, surveillance, laboratory diagnostics, contact tracing, infection prevention and control, and community engagement. In the case of mpox, severe cases are treated as inpatients in a mpox treatment center (CT Mpox); mild and moderate cases can be treated as outpatients in Centres de Santé or health posts (Postes de Santé). By May 26, 2024, 7,851 mpox cases and 384 deaths had been reported; these figures covered 177 of 519 health zones in 22 of 26 provinces and are not a current nationwide prevalence figure. After treatment, the care pathway includes discharge or referral follow-up, continuation of vaccinations, postnatal checkups, chronic medicines, and nutritional and psychological or psychosocial support. Continuity is especially vulnerable for chronic illnesses, after childbirth, and after an acute infection when medicines are unavailable, routes are unsafe, or a facility closes. Malaria, maternal, newborn, and child health, malnutrition, measles, cholera, mpox, HIV, and tuberculosis strongly shape demand. Noncommunicable diseases and mental health are also becoming more important, while major gaps in care remain. For childbirth and newborn care, the program free childbirth and newborn-care program (gratuité des accouchements et soins du nouveau-né) is available. In 2024, it recorded 2,649,270 free births in 14 provinces. A nationwide expansion to all 26 provinces was announced for 2026; the current status and the exact scope of services must be confirmed with the responsible province or facility. This does not support a blanket assumption of free healthcare throughout the country. For other services, there is no reliable nationwide uniform tariff. Direct household payments remain a major barrier to access; insurance and financing questions largely belong to the cost or insurance topics. The Institut National de Santé Publique (National Institute of Public Health, INSP) is responsible, among other things, for research, training, and health surveillance. The Agence Nationale de Médicament (National Medicines Agency, ANAMED) deals with essential medicines, while ACOREP supports medicine quality and safety. ARC-CSU regulates general healthcare, FSS stands for solidarity financing, and FPS for prevention and health promotion. The health law Loi No 18/035 of 2018 sets out basic principles of public health. For people living with HIV, Loi No 08/011 documents specific legal protection. In North Kivu, according to a 2025 WHO snapshot, around 70 percent of health facilities were not operational. In 2026, the Health Cluster estimated that about 7.5 million people needed life-saving healthcare; insecurity, displacement, attacks, and supply shortages make access particularly difficult in the eastern provinces. Traditional medicine is regulated and promoted by the ministry, but in remote areas it often remains an informal and variably reliable first point of contact. Formal equality with clinical care has not been established; referral, infection prevention, and quality control are inconsistent. A nationwide uniform emergency number, a central appointment portal, a comprehensive fee schedule, and consistently reliable access everywhere have not been reliably verified.